WHO--On the Road to Observer Status

Byline:PAT GAO

Publication Date:05/01/2003

Since 1997, Taipei has sought observer status in the World HealthOrganization (WHO). It can gain such status upon the invitation ofthe secretary-general or through a vote by members of the healthbody. Since the organization was established by the United Nations,of which Taiwan is not a member, Beijing's opposition has so farstymied both approaches. Taiwan's allies, however, have continuedto present proposals to the World Health Assembly (WHA)--WHOannual meetings--calling for Taiwan's affiliation with the globalhealthcare agency. After years of effort, Taiwan's WHO campaignhas won increasing sympathy and support from many WHO membersand the international health community as a whole. Taiwan Review'sPat Gao interviews three major advocates of Taiwan's entry into theWHO.

Twu Shiing-jer, director-general of the Departmentof Health (DOH), who heads a committee formed in 2001that integrates the resources of various governmentaldepartments and nongovernmental organizations at homeand abroad to promote Taiwan's WHO bid. In 1997, whenhe worked for the Taipei City Government as the directorof its Bureau of Health, he became the first health officialin the local government to join Taiwan's WHO campaignin Geneva.

You were among the first advocates to promote Taiwan's WHO cause. Why did you start pursuing entry, and why is it crucial for national interests?

About eight years ago, as a member of the Taiwan Public Health Association's board of directors, I proposed international healthcare as the subject of its seminar. Taiwan is larger than three-quarters of the countries in the world in terms of population, and is also one of the world's major trading nations. A country of such significance, however, seems to have been inappropriately dwarfed on the international stage.

If political means cannot be relied on to defend our national dignity, aren't nonpolitical issues such as health affairs the ideal focus for our overseas efforts? In fact, even if we successfully enter the WHO, it doesn't necessarily count as a diplomatic achievement. As you can see, there are many countries that become WHO members without any diplomatic efforts whatsoever, but Taiwan is in a unique situation. After all, there is no national boundary restricting diseases and other health concerns. Although the political reality is never easy to transcend, our position is becoming increasingly tenable in the international community. On the other hand, Beijing's opposition is only assuming greater absurdity.

Is international support strong enough right now for Taiwan's WHO bid?

The WHO's mandate is to achieve the highest possible level of healthcare for all people in the world. Such a universally recognized claim of health as a humane issue cannot fail to win sympathy in the international community, but, to tell the truth, concrete support may not follow because political concerns will override good intentions. Therefore, if we want a real breakthrough, we must transform our WHO efforts into a rational argument for other countries, provide examples of our many efforts at improving healthcare, and expand our health-related programs. In other words, we must try harder to provide medical aid abroad, to make friends through healthcare contacts, and to assume international responsibilities as a world citizen.

If we establish true humanitarian bonds with other countries in this way, their support for our WHO cause is bound to increase. In this respect, we hope to encourage more people to become involved in health-related activities. For one thing, the percentage of the population in Taiwan engaged in some kind of volunteer work is much lower than that in the United States and Japan. If people are reluctant even to contribute aid locally, how can you expect them to do so internationally?

How should Taiwan develop its human resources with regard to global health affairs?

Because of Taiwan's extended isolation in foreign relations, we're short of the specialists that WHO participation would require. We would need, for example, qualified experts to speak eloquently at international meetings. I'm afraid that once we're admitted to the WHO, we may have difficulty in recruiting enough people qualified in both medicine and diplomacy. Therefore, the DOH is putting a great deal of energy into relevant training programs. For example, we host an international public-health workshop each year that invites medical specialists from more than 30 countries. Last year, the DOH sent three doctors as health diplomats to Washington, Geneva, and Malawi to promote international exchanges on health affairs, especially WHO-related matters.

Wu Shuh-min, president of the Foundation ofMedical Professionals Alliance in Taiwan (FMPAT),physician, clinical professor at Taipei Medical University,and national policy advisor to the President. Establishedin 1992 to expand Taiwan's presence in the internationalmedical field, the FMPAT works with the government toadvance Taiwan's connections with the WHO. Since 1997,the FMPAT has held annual student-training camps onpublic health and foreign affairs to educate youths aboutglobal participation and international law.

How does the FMPAT help the government with the WHO cause?

When we started to seek connection with the WHO, the then ruling Kuomintang was quite indifferent to our efforts. Our relationship with the governmental sectors improved through continual exchanges and effective cooperation. Since the Democratic Progressive Party came into power, we have maintained even closer contacts with relevant ministries and departments that, on our recommendation to the President, have formed a committee to integrate resources. Each year, we go to Geneva to communicate with WHO members and to lobby on Taiwan's behalf.

I remember that,about three years ago, during a WHA annual meeting, a long round of applause followed the speeches made by Taiwan's allies in support of its affiliation with the WHO. This indicates the considerable international recognition we've won. Recently we've adopted different strategies. In addition to visiting Geneva, we visited major WHO member states such as Japan, France, and Belgium. Both before and during the visits, we established contacts with local media. Our approach worked especially well in Japan, where all major media reported on Taiwan's WHO campaign.

In light of the health and medical needs, what are the major concerns driving Taiwan's efforts to secure participation in the WHO?

In the event of a medical emergency, we would have to handle the crisis on our own. Why do Taiwan's people have to suffer like this? Take for example the 1998 outbreak of enterovirus 71 that killed dozens of children. Foreign assistance did come, such as that from the United States, but only belatedly and indirectly through private channels. Moreover, our medical achievements could have contributed to public health around the world through the WHO network. Taiwan has made remarkable advances in recent years in eradicating such infectious diseases as malaria and polio. And Taiwan's National Health Insurance program is among the most advanced systems in the world. Such knowledge and skills must be allowed to benefit the world through the existing and highly effective channels of the WHO.

How should Taiwan counter Beijing's opposition?

After decades of national development, we have won respect mainly as a democracy, as well as a major economic power. Enjoying the international acclaim resulting from our democratic achievements, we can continue to make all possible efforts, so as to make China try ten times harder to stop us. Last year, the European Parliament joined the voices supporting our WHO cause. We can take advantage of this collective support, and China will have a harder time intimidating large blocks of supporters.

Lee Ying-yuan, deputy secretary-general of theruling Democratic Progressive Party. He was former vicechairman of the World United Formosans for Independence,legislator, deputy representative to the United States, andsecretary-general of the Executive Yuan. He holds a doctoraldegree of health economics.

Please talk about your personal participation in Taiwan's WHO efforts.

Due to my academic and professional background, I've had a continual interest in Taiwan's WHO bid, which concerns both health and diplomatic matters. When I was a university student, I majored in public health and read a lot about the WHO and its research. At that time, Taiwan was still a WHO member. Many Taiwanese medical specialists had experience working for the WHO, and Taiwan had received considerable help from the organization in quite a few public health projects, such as the eradication of tropical diseases.

In 1997, when our nongovernmental groups started to work on seeking Taiwan's WHO membership, I was a member of the Foreign and Overseas Chinese Affairs Committee in the Legislative Yuan. Together with other legislators, doctors, experts, and activists in the medical field, I went to the WHO headquarters in Geneva where the organization was holding its annual meeting. We gathered in front of the assembly building, distributed pamphlets, and expressed our standpoint, trying to impress representatives from WHO member states. Later, as deputy representative to the United States, I formed connections with relevant health organizations and departments of the US government that could help Taiwan enter the WHO.

How do you see the progress of Taiwan's WHO cause?

It's not easy. In fact, nothing that involves politics is easy, especially as the WHO is closely affiliated with the United Nations. However, we've made slow but substantial progress in the past five to six years. In 2001, for example, the head of the US Department of Health and Human Services made a statement in Geneva in support of Taiwan's participation as an observer in the WHO and reconfirmed this stance with more specific details last year. Some European countries and Japan have also shown support for our WHO campaign. Good health is a basic human right for everyone in the world. Our call for direct access to information and resources in the global health network in order that our people can receive immediate and timely care in case of the threat of fatal diseases is irrefutable.

So, you're optimistic?

We cannot afford to be pessimistic, and I have a natural inclination toward optimism anyway. During my personal involvement in Taiwan's democratic movements, I have seen so many difficulties be overcome. Likewise, in the WHO case we must continue to do all that we can in spite of political obstacles. If successful, it will set a model for Taiwan's further campaigns for the membership in other international organizations. The crucial factor now is national agreement among the ruling and opposition parties in the government and among the people and, despite minor controversies over technical problems, that agreement is tangible enough.